title: Bone marrow edema induced by a bullet after a self-inflicted accidental firing.
abstract: We present a case of a postmortem finding of bone marrow edema in postmortem magnetic resonance imaging (PMMR) indirectly induced by a bullet, which barely missed the bone of a 92-year-old man found kneeling in front of his bed of a tidy apartment. Additionally, a selective postmortem computed tomography angiography (PMCTA) of the left leg was performed, visualizing a laceration of the left femoral vein by the bullet with consecutive contrast media extravasation. A vast pulmonary fat embolism was diagnosed and together with the blood loss found to be the cause of death.
authors.affiliation: Department of Forensic Medicine and Radiology, Institute of Forensic Medicine, University of Zurich, Switzerland; Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Switzerland. Electronic address: nicole.berger@usz.ch.
authors.forename: Nicole
authors.initials: N
authors.lastname: Berger
authors.forename: Pia
authors.initials: P
authors.lastname: Paula
authors.forename: Dominic
authors.initials: D
authors.lastname: Gascho
authors.forename: Patricia M
authors.initials: PM
authors.lastname: Flach
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Thali
authors.forename: Steffen G
authors.initials: SG
authors.lastname: Ross
authors.forename: Garyfalia
authors.initials: G
authors.lastname: Ampanozi
mesh_terms: D000369:Aged, 80 and over; D000792:Angiography / Q000295:instrumentation / Q000379:methods; D001853:Bone Marrow / Q000000981:diagnostic imaging / Q000473:pathology*; D002423:Cause of Death; D004487:Edema / Q000000981:diagnostic imaging / Q000473:pathology*; D004620:Embolism, Fat / Q000150:complications / Q000000981:diagnostic imaging / Q000209:etiology; D005268:Femoral Vein / Q000000981:diagnostic imaging / Q000293:injuries; D049429:Forensic Pathology / Q000295:instrumentation / Q000379:methods*; D006470:Hemorrhage / Q000150:complications / Q000000981:diagnostic imaging / Q000209:etiology; D006801:Humans; D007869:Leg Injuries / Q000000981:diagnostic imaging / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging / Q000209:etiology; D014057:Tomography, X-Ray Computed; D014948:Wounds, Gunshot / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology*
keywords: Bone bruise; PMCT; PMCTA; PMMR; Postmortem MRI; Postmortem computed tomography; Postmortem computed tomography angiography; Virtopsy